Lima Marcelo M S, Targa Adriano D S, Dos Santos Lima Gustavo Z, Cavarsan Clarissa F, Torterolo Pablo
Neurophysiology Laboratory, Department of Physiology, Federal University of Paraná, Curitiba, Paraná, Brazil.
CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain.
Int Rev Neurobiol. 2024;174:187-209. doi: 10.1016/bs.irn.2023.08.008. Epub 2023 Dec 1.
Sleep disturbances are highly prevalent among patients with Parkinson's disease (PD) and often appear from the early-phase disease or prodromal stages. In this chapter, we will discuss the current evidence addressing the links between sleep dysfunctions in PD, focusing most closely on those data from animal and mathematical/computational models, as well as in human-based studies that explore the electrophysiological and molecular mechanisms by which PD and sleep may be intertwined, whether as predictors or consequences of the disease. It is possible to clearly state that leucine-rich repeat kinase 2 gene (LRRK2) is significantly related to alterations in sleep architecture, particularly affecting rapid eye movement (REM) sleep and non-REM sleep, thus impacting sleep quality. Also, decreases in gamma power, observed after dopaminergic lesions, correlates negatively with the degree of injury, which brings other levels of understanding the impacts of the disease. Besides, abnormal synchronized oscillations among basal ganglia nuclei can be detrimental for information processing considering both motor and sleep-related processes. Altogether, despite clear advances in the field, it is still difficult to definitely establish a comprehensive understanding of causality among all the sleep dysfunctions with the disease itself. Although, certainly, the search for biomarkers is helping in shortening this road towards a better and faster diagnosis, as well as looking for more efficient treatments.
睡眠障碍在帕金森病(PD)患者中非常普遍,且常常在疾病早期或前驱期就出现。在本章中,我们将讨论目前有关PD睡眠功能障碍之间联系的证据,重点关注来自动物模型以及数学/计算模型的数据,还有基于人类的研究数据,这些研究探索了PD与睡眠可能相互交织的电生理和分子机制,无论其是作为疾病的预测因素还是后果。可以明确指出,富含亮氨酸重复激酶2基因(LRRK2)与睡眠结构改变显著相关,尤其影响快速眼动(REM)睡眠和非快速眼动睡眠,从而影响睡眠质量。此外,多巴胺能损伤后观察到的γ功率降低与损伤程度呈负相关,这为理解该疾病的影响带来了其他层面的认识。此外,考虑到运动和睡眠相关过程,基底神经节核之间异常的同步振荡可能对信息处理有害。总之,尽管该领域取得了明显进展,但仍然难以确切全面地理解所有睡眠功能障碍与疾病本身之间的因果关系。不过,寻找生物标志物肯定有助于缩短通往更好、更快诊断的道路,以及寻找更有效的治疗方法。